A patient with a complex history and great hope turned to us for correction. A tertiary rhinoplasty lay ahead — a challenge that always demands from the surgeon not only maximum technical precision and exquisite craftsmanship but also deep empathy, as the patient already has a negative surgical experience behind her.
Initial Anatomical Features
The two previous interventions did not bring the young woman the desired aesthetic result. Moreover, they severely disrupted the anatomical structure. Due to multiple interventions, the nasal framework was weakened, and there were pronounced scar tissue changes, tip asymmetry, and dorsal irregularities. As is often the case after unsuccessful surgeries, aesthetic discomfort was accompanied by functional issues — the patient experienced severe difficulties with nasal breathing due to the deformation of internal structures.
Course of Surgery
My main task was not merely to visually harmonize the face, but, in essence, to rebuild a healthy, strong nasal architecture. Tertiary rhinoplasty almost always implies working under conditions of severe cartilage tissue deficiency, which is why the operation was reconstructive in nature. I used an open approach — this gave me the necessary visibility for the meticulous excision of scar tissue and the precise restoration of anatomical supports. The patient’s moderately thick skin further complicated the task, as the formation of a refined tip under such conditions requires special surgical techniques.
Result
The result you see immediately upon completion of the surgery was worth all the effort applied. I managed to form an elegant, straight dorsum and a neat, structural tip with proper projection. The basal view demonstrates excellent nostril symmetry. The patient’s face instantly acquired softness and noble proportions. And, just as importantly, we reopened the airways, restoring her ability to breathe freely and fully. The process of rehabilitation and the subsiding of swelling still lies ahead, but I can already see that we have achieved a wonderful aesthetic and functional balance that will restore the patient’s self-confidence.
